The Results of Transscleral Diode Laser Cyclophotocoagulation in Micropulse Mode Treatment in Patients with Primary Subcompensated Open-Angle Glaucoma and Toxic-Allergic Syndrome of the Ocular Surface

Purpose: to analysis the results of microimpulse transscleral diode laser cyclophotocoagulation (DCPC) technique as a method of choice in patients with open-angle subcompensated glaucoma (OAG) with toxic allergic syndrome of the ocular surface (TASOS).

Methods. The retrospective analysis of patients’ case reports with subcompensated open-angle glaucoma and TASOS was performed. Transscleral diode laser cyclophotocoagulation (DCPC) in a microimpulse mode was used in their treatment. A total of 19 patients’ case reports were analyzed.

Results. In the postoperative period, its course, patient’s complaints, ophthalmological status, visual acuity indicators were determined. The level of intraocular pressure was measured. Almost all patients (84.2 %) reached the target level of IOP. The frequency of side effects was low. In 36.84 % of patients, symptoms of TASOS decreased in response to hypotensive treatment due to reduction of instillation frequency.

Conclusion. The use of micro-pulse cyclophotocoagulation in patients with subcompensation form of OAG and toxic-allergic ocular surface syndrome (TASOS) reduces the intensity of the drop regime of antihypertensive drugs. As a result, the manifestations of TASOS are reduced, which increases the patients’ quality of life in the postoperative period. In addition, the use of DCPC in microimpulse mode leads to stabilization of functional and structural indicators, helps to prevent a decrease in visual functions. Thus, the described method is characterized by safety, high efficiency and a wide range of indications for its performance. It allows to compensate the IOP with a minimum percentage of complications and stable postoperative results.

1. Loskutov I.A. Study of the accuracy of anti-glaucomatous instillation regimen following in glaucoma patients. Clinical pharmacology and therapy = Klinicheskaja farmakologija i terapija. 1997; 6:18–19 (In Russ.)

2. Mihailova T.N. “Personalised approach to glaucoma treatment — the Grail of ophthalmology... ” Bausch&Lomb Satellite Symposium. The Russian ophthalmology online. 2018;29 (In Russ.)

3. Fechtner R.D., Godfrey D.G., Budenz D. Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure-lowering medications. Cornea. 2010;29(6):618–621. Doi: 10.1097/ICO.0b013e3181c325b2

4. Iyer J.V., Zhao Y., Lim F.P.M. Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis. Clin. Ophthalmol. 2017;11:1191– 1196. DOI: 10.2147/OPTH.S134570

5. Cannon P.S., Spencer A.F., Lavin M. Good functional recovery following intervention for delayed suprachoroidalhaemorrhage post bleb needling: a case report. J. Med. Case Rep. 2008; 2:81. DOI: 10.1186/1752-1947-2-81

6. Demirel S., Doganay S., Gurses I. Toxic-inflammatory effects of prostaglandin analogs on the ocular surface. Ocul. Immunol. Inflamm. 2013;21(1):13–18. DOI: 10.3109/09273948.2012.723106

7. Skalicky S.E., Goldberg I., McCluskey P. Ocular surface disease and quality of life in patients with glaucoma. Am. J. Ophthalmol. 2012;153:1–9.e2. DOI: 10.1016/j.ajo.2011.05.033

8. Baudouin C., Labbé A., Liang H. Preservatives in eye drops: the good, the bad and the ugly. Prog. Retin. Eye Res. 2010;29:312–334. DOI: 10.1016/j.preteyeres.2010.03.001

9. Baudouin C. Ocular surface and external filtration surgery: Mutual relationships. Dev. Ophthalmol. 2017;59:67–79. DOI:10.1159/000458487

10. Kazanceva A.Yu. A new pathogenetic method of treatment of patients with advanced glaucoma. Russian ophthalmological journal = Rossiyskiy oftal’mologicheskiy zhurnal. 2020;1:21–25. (In Russ.) DOI: 10.32364/2311-77292020-20-1-21-25

11. Egorov E.A., Astaxov Yu.S., Erichev V.P. National guide to glaucoma, Moscow: GEOTAR-Media; 2019;4:384 (in Russ.). DOI: 10.33029/9704-5242-8-2020-1-384

12. Egorov V.V., Sorokin E.L., Marchenko A.N., et al. Transcleral diodlaser coagulation of the ciliary body in the treatment of terminal painful glaucoma. Russian Medical Journal. Clinical Ophthalmology = Rossijskij medicinskij zhurnal. Klinicheskaya oftal’mologiya. 2007;4:142 (In Russ.)

13. Uram M. Ophthalmic laser micro end endoscopephotocoagulation. Ophthalmol. 1992;99:1829–1832. DOI: 10.1007/s12009-002-0052-2.

14. Gavrilova I.A., Plotnikova Yu.A., Chuprov A.D. Experience in the use of transscleral diode laser cyclophotocoagulation in eyes with intact visual functions. Point of view. East — West. Point of view. East-West = Tochka zrenija. Vostok — Zapad. 2014;2:31–32 (In Russ.)

15. Aleshaev M.I., Golikova M.S., Zarubina O.A. Micropulse laser trabeculoplasty in the treatment of patients with primary open-angle glaucoma. Russian ophthalmology online = Rossijskaja oftal’mologija onlajn (In Russ.). https://eyepress.ru/article.aspx?8351

16. Antonova A.V., Nikolaenko V.P., Brzheskiy V.V. Ophthalmic hypotensive therapy and the eye surface of patients with glaucoma. Part 1. Effect of the drug substance of antihypertensive drugs on the eye surface. Russian Medical Journal. Clinical Ophthalmology = Rossiyskiy medicinskiy zhurnal. Klinicheskaya oftal’mologiya. 2020;2:79–84 (In Russ.).

17. Nesterov A.P., Egorov E.A., Egorov A.E. Effect of transcleral laser cyclocoagulation on intraocular pressure and visual functions in patients with lowpressure glaucoma. Russian Medical Journal. Clinical Ophthalmology = Rossiyskiy medicinskiy zhurnal. Klinicheskaya oftal’mologiya 2001;2:56–57 (In Russ.).

18. Schlote T., Grub M., Kynigopoulos M., Long-term results after transscleral diode laser cyclophotocoagulation in refractory posttraumatic glaucoma and glaucoma in aphakia. Graefes Arch Clin Exp Ophthalmol. 2008;246(3):405–410. DOI: 10.1007/s00417-007-0708-0

19. Ansari E., Gandhewar J. Long-term efficacy and visual acuity followeingtransscleral diode laser photocoagulation in cases of refractory and non-refractory glaucoma. Eye. 2007;21:936–940. DOI: 10.1038/sj.eye.6702345

20. Quigley H.A., Broman A.T., The number of people with glaucoma worldwide in 2010 and 2020. Br. J. Ophthalmol. 2006;90(3):262–267. DOI: 10.1136/bjo.2005.081224